The U.S. Department of Health and Human Services (HHS) released standards for electronic funds transfers (EFT) and electronic remittance advice (ERA) transactions for health plans’ electronic payments to healthcare providers. 

 

The Interim Final Rule, released in 2012, does not require healthcare providers to accept payments electronically. However, effective Jan. 1, 2014, if a provider wants to receive payment electronically, a health plan must oblige and conduct the transaction in compliance with standards identified in the Interim Final Rule. 

 

Guidance issued by HMS on March 22, 2022, under GL-2022-04, confirms the information noted above. In addition, that guidance and CMS FAQs published July 14, 2022, specify that while a health plan can pay claims using Virtual Credit Cards (VCCs), if a provider requests payment be made via EFT through the Automated Clearing House (ACH) Network instead of a VCC, the health plan must comply with the request.  There is however, no requirement that a health plan honor a request for claims to be paid via a paper check.